Treatment

Who Needs It, How to Get It

If you have a fever with a cough or sore throat, you can take steps to protect yourself and avoid spreading illness to others.

People with flu usually recover without medical treatment. Stay home from work or school until you have been free of fever for at least a day. But other illnesses can cause fever, so call your doctor if you are in doubt.

If you are at risk of complications (see list below), call your doctor to discuss treatment with antiviral medicine. You may not need to visit the doctor’s office or clinic; if appropriate, the doctor can call a pharmacy with your prescription.

If you have a severe or worsening symptoms, such as difficulty breathing, go immediately to a hospital emergency room.

If you do not have severe illness, you do not need to go to a hospital.

Rest, drink plenty of liquids, and take the medications you would normally take to treat your symptoms (for example, acetaminophen or ibuprofen). People under 18 years old should not take aspirin or aspiring-containing products such as Pepto-Bismol™. Aspirin can cause a rare but serious illness called Reye’s syndrome in young people with flu.

What are medicines that can prevent or treat influenza?

Two separate vaccines will be available this fall to prevent influenza: one for seasonal flu, and one for H1N1 (“swine flu”). There are also two drugs to prevent and treat both strands of flu: oseltamivir (Tamiflu®) and zanamavir (Relenza®). The first is taken orally, the other is inhaled. These medications, which require a doctor’s prescription, are known as antivirals. They can prevent severe illness by helping your body combat influenza viruses.

Who should take these medicines?

Most people recover completely from influenza without medication, but certain people are at higher risk of severe illness or complications. If you or a family member meet one of the descriptions on the list below, and you develop flu-like illness (fever accompanied by cough or sore throat) or have had recent close contact with someone with flu-like symptoms, please call your doctor or clinic to discuss treatment with antiviral medicine.

Those at higher risk for flu complications include:

People over 65 or under 2 years of age

Pregnant women

Women who have given birth, or had a miscarriage or abortion in the past 2 weeks

People with chronic lung problems, such as asthma or emphysema

People with chronic heart, kidney, liver or blood disorders

People with neurological disorders that can cause breathing problems

People with diabetes

People whose immune systems are weakened due to illness or medication

People under 19 years who are on long-term aspirin therapy

If you belong to one of these higher-risk groups, and you’re in close contact with someone who has influenza, a health-care provider may recommend that you take antiviral medicine as a precaution.

Should I be tested for influenza before being treated for it?

No, you don’t need a flu test to receive treatment for flu-like illness. Testing to confirm influenza infection should be reserved for people who are critically ill.

How can I get a prescription?

The Health Department recommends that doctors prescribe treatment for anyone with flu-like illness who belongs to any of the higher-risk groups listed above. If you or a family member are at higher risk and you develop flu-like illness, take your temperature. If the reading is 100 degrees or higher, call your health care provider and explain that you have flu-like illness and may be at risk of complications. You do not need to go to a hospital unless your symptoms are severe. The provider may want to see you, or may be able to prescribe treatment by calling your pharmacy.

Are antiviral medicines available at my local pharmacy?

They should be. The Health Department is assessing the availability of antivirals at New York City pharmacies, and finding that most have steady supplies. Before going to the pharmacy to fill a prescription, you may save time by calling first to make sure the medication is available. If the pharmacy you usually use does not have the medication, call other pharmacies in your neighborhood. Large chain pharmacies are reporting good supplies of antiviral medication. Pharmacies charge different prices for the same drugs, so you may want to check a few different outlets before filling your prescription. You can search for nearby pharmacies here.

Do these medicines come in liquid form?

Oseltamivir (Tamiflu®) is available as a liquid. It is used for children or those unable to shallow pills. If you need fill a prescription for the liquid form, call your pharmacist first to make sure it is available. Large pharmacies are reporting good supplies. If your pharmacy doesn’t have the liquid form in stock, the pharmacist may be able to create it for you from capsules – a process called compounding. Not all pharmacies are capable of compounding.

I need antiviral medication but don’t have a regular doctor. How can I get a prescription?

Every New Yorker should have a regular doctor or other health provider. If you don't have a regular provider, you can get one through your health plan. And if you don’t have a health plan, you may qualify for free or low-cost health insurance. To find out, call 311 and ask about HealthStat.

If you need treatment immediately and don’t have access to health coverage, you can search for available services. New York City’s public hospitals and community clinics will care for anyone in need, and will charge according to the person’s ability to pay. Facilities operated by the New York City Health and Hospitals Corporation (www.nyc.gov/hhc) set fees for services and medicine according to people’s ability to pay. Services are also available at low cost or no cost through federally funded health centers. To find federally funded health centers near you go to http://findahealthcenter.hrsa.gov/ and enter your zip code. These health centers can provide:

Checkups when you're well

Treatment when you're sick

Complete care when you're pregnant

Immunizations and checkups for your children

Dental care for your family

Mental health and substance abuse care if you need it

Prescription drugs

Before visiting a health center, you can call to schedule an appointment or find out if there is a clinic even closer to you.

What if I can’t afford medications for influenza?

Patients receiving services through the Health and Hospitals Corporation may qualify for free or discounted medications. Some federally funded health clinics also provide prescription drugs to their patients, but antiviral medicine is not currently available through these programs.

When should I go to the hospital?

If your symptoms are bad and getting worse, or you have a medical condition such as heart disease, immune deficiency, diabetes, or severe asthma you should contact or visit a doctor or a hospital right away. If you aren’t sure where to get care, call 311 or visit www.nyc.gov/flu for information. Care is always available if you need it, and no one will check your immigration status. Here are some signs that you may need medical treatment:

Adults

Trouble breathing or shortness of breath

Pain or pressure in the chest or stomach

Sudden dizziness

Confusion

Severe vomiting that won’t stop

Children

Fast breathing or trouble breathing

Bluish skin color

Fever with a rash

Refusing to drink fluids

Vomiting or diarrhea that won’t stop

Not waking up or not interacting

Being too irritable to be held

Having flu symptoms return with fever and worse cough after starting to get better

Worried about Flu? What you should do

IF YOU ARE

AND YOU HAVE

YOU SHOULD

Not at High Risk

Fever (100) plus cough or sore throat

Stay home until you’ve felt completely well for a day. Don’t go to a hospital.

* High Risk

Fever (100) plus cough or sore throat

Call your doctor to discuss whether you need medicine for flu. Don’t go to a hospital.

Anybody with severe illness like difficulty breathing

Fever (100) plus cough or sore throat

Get to a hospital right away. If you call 911, say you may have severe influenza.